Nine-year-old paraplegic re-learns how to walk at Cal State L.A.
Mobility Center and Spinal Cord Injury Exercise Research Laboratory to aid in gait training
With grins and giggles, nine-year-old Katarina Stankovich pokes fun at the college students training her, while she ÂwalksÂ with conviction and help, even though she is a paraplegic without the use of her legs.
Her progress can be credited to her courageous family, Cal State L.A.Âs Kinesiology Professors Ray de Leon and Christine Dy, and the kinesiology students who volunteer in the UniversityÂs Mobility Center and Spinal Cord Injury Exercise Laboratory.
Now Katarina is initiating steps on her own on state-of-the-art equipment in the lab. In particular, locomotor training on a treadmill, which uses a body harness connected to a pneumatic lift to partially unload KatarinaÂs body weight from her legs as she walks to improve her gait during rehabilitation sessions.
ÂMy ultimate end result for Katarina here in the lab would be for her to walk out of here one day,Â said her mother Natasha Milatovich.
While on the treadmill, KatarinaÂs steps are first initiated with the help of volunteer CSULA kinesiology and other students who place her feet and legs in the right positions so she can walk during her therapy. Then she is asked if she would like to take steps on her own.
When asked who her favorite trainer is, Katarina diplomatically says, ÂAll of them,Â with a chuckle. ÂItÂs a lot of fun here and they all help me a lot.Â
Initiating her own steps is a major accomplishment for Katarina, considering the original diagnoses she received from ChildrenÂs Hospital in Los Angeles just a few weeks after the car accident in Fresno in 2005.
ÂIÂll never forget,Â said Milatovich. ÂIÂm sitting there in my own bandages at KatarinaÂs bed. She didnÂt know what was happening to her. In her mind she was still a normal four-year-old who was into ballet, athletics and other things. But then I had this doctor telling me, ÂShe will never walk again. ThatÂs the reality.Â I thought ÂDid I just hear this? She is only four years old.ÂÂ
Katarina injured her spinal cord at the T-10, L-1 level in the accident, which resulted in paralysis below the middle of her abdomen. The rollover accident, which took one life, changed KatarinaÂs and her familyÂs lives forever. MilatovichÂs and her son, Stefan, both required surgery after the accident in 2005, but they recovered fully. Six years later, rehabilitation and trips to see specialists for Katarina are an integral, and often fatiguing, part of their lives.
It wasnÂt until Milatovich started taking Katarina to the Casa Colina Center for Rehabilitation in Pomona that she found therapy that she felt would be beneficial. The center utilized the same treadmill system that she would later find at CSULA. Unfortunately, it was not cost effective for the center to have several employees help Katarina during her sessions. Milatovich and her family began helping move her legs on the treadmill at the center as a therapist adjusted the treadmillÂs speed and body harness system during training.
Katarina and Milatovich also traveled to Baltimore to the Kennedy Kreiger Institute, a research institute for John Hopkins. There a man, who is a quadriplegic, walked up on his own and was introduced to them. Their doctor said, ÂIf he can do it, so can you Katarina. ItÂs not a matter of Âif,Â itÂs a matter of Âwhen.ÂÂ
At the institute, which Katarina now visits once a year to check her progress, she also uses a similar treadmill system and a stationary bicycle for therapy. The therapy is designed to help retrain the brain to mentally connect to the movement of her legs, which is only possible if some nerve impulses still pass through the spinal cord. Gait therapy is usually ruled out for those whose spinal cords are completely severed.
Mobility Center and Spinal Cord Injury Exercise Research Lab at CSULA
Eventually, Milatovich heard through a friend at work about the Mobility Center and Spinal Cord Injury Exercise Research Lab at CSULA, and how there are many students who are integrally involved in the physical aspects of the rehabilitation process. The CSULA students now provide the physical support for Katarina that Milatovich and her family had to do on their own.
Both the center and lab in CSULAÂs School of Kinesiology and Nutritional Science utilize a service-learning model to provide functional and therapeutic exercise to campus- and community-based populations, primarily in east and central Los Angeles.
According to Dy, the mission of the program is to provide functional and therapeutic rehabilitation to impaired individuals while offering service learning opportunities for CSULA students. The program also strives to serve physically impaired individuals who are uninsured, underinsured and who continue to seek ways to improve their physical and emotional well-being through physical trainer-assisted functional and therapeutic exercise.
ÂWith the Spinal Cord Injury Exercise Research Lab and in our other related facilities, kinesiology students are able to learn and be trained, because they work side-by-side with faculty on research projects while providing rehabilitation services to our clients,Â said Dy. ÂThe other goal is to improve the quality of life by encouraging physical activity as well as documenting the productivity of these endeavors.Â
Dy continued, ÂThe vast majority of students who help with clients like Katarina in the lab are future physical therapists or occupational therapists, while others are interested in research. Most of our clients donÂt mind us including them in on research projects with the students if it helps further spinal injury research and science.Â
CSULA Kinesiology student Eunice Wong, who wants to be physical therapist after graduating this spring, helps Katarina and others with a variety of exercises.
ÂWorking here takes a lot. Katarina needs a lot of attention. Plus, she is a little girl [the only child client in the lab], so we really have to bring ourselves to her level to relate to her,Â said Wong. ÂWe canÂt treat her like our adult clients. We have to think like a kid.Â
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* Kinesiology labs at CSULA:
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* School of Kinesiology and Nutritional Science at CSULA:
* College of Health and Human Services at CSULA:
Last year, the Mobility Center and the Spinal Cord Injury Exercise Research Lab were awarded $6,000 from Building Healthy Partnerships, the Kaiser Permanente Los Angeles Medical Center Communities Benefits Program. The funding enabled CSULA to increase the programÂs capacity to provide functional and therapeutic exercise for individuals with physical impairments and to provide leadership opportunities for students.
The grant has made an impact. de Leon acknowledges the strides Katarina has made since first becoming a client. ÂNot too long ago, Christine showed me some video of Katarina and I was like Âwow, thatÂs something. There is a lot of improvement there,ÂÂ he said. ÂShe can now walk. ThatÂs what I saw. Before she needed a lot of help from the trainers. But now she can walk to some extent.Â
Besides being able to initiate her steps on the treadmill, Katarina may also hold her own weight with control.
ÂThere has been great progress. At first, she only had feeling at the belly button and above, but now she can feel neurologically down to her quads,Â said Milatovich. ÂNow, sheÂll say, ÂI want to self-initiateÂ and actually move her legs on the treadmill herself. ThatÂs when the students get really excited. This really builds KatarinaÂs self-esteem. She feels like a star.Â